“Vital Longevity” – Cardiovascular Health is
Key on Many Fronts
The Role of Vegetables in Our Diet – Now
More Important than Ever
Emotions Have Significant Impact on Health
and Longevity
Resolution Optimal Health
Lean and Mean Memory
FEATURED RECIPES – TOP 10 POWER FOOD SELECTIONS
Skillet Broccoli – One-Dish Meal with variations
Thai Tofu and Kabosha Squash Stew with Chard
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“Vital Longevity” – Cardiovascular Health is Key on Many
Fronts
- Heather Peña M.D., Medical Director, St. Helena
Center for Health
We all strive for a quality of life that will allow us to enjoy
living well for many years to come. Nobody wants to be old and
“frail”. Vitality comes easily to some and is more of a struggle for
others. It turns out that keeping your heart and arteries healthy
not only prevents heart attacks and strokes, but also prevents
“frailty and weakness” in our later years.
At the Center for Health we like to utilize every state of the art
tool available to predict and prevent cardiovascular disease and
thereby promote a vital long life. I’ll discuss three of these
below.
Staving off frailty as we age
One of the persistent mysteries of aging, say researchers, is why
one person remains so hale and hearty while another, who had seemed
just as healthy, starts to weaken and slow down, sometimes as early
as his 70’s. The state of one’s cardiovascular health over the long
term may provide the key.
“The question,” says Dr. Tamara Harris, chief of the geriatric
epidemiology section at the National Institute on Aging, “is why
some age well and others do not, often heading along a path that
ends up in a medical condition known as frailty.” Dr. Harris
explains that frailty involves exhaustion, weakness, weight loss and
a loss of muscle mass and strength. “It means that some people spend
a long time in a period of their life where they have lost
function,” she says. Those who are looking toward their 60’s, 70’s
and beyond obviously find that very distressing, and there is also a
tremendous health care cost.”
Now, though, scientists are surprised to find that, in many cases, a
single factor — undetected cardiovascular disease — is often a major
reason people become frail. They may not have classic symptoms like
a heart attack or chest pains or a stroke. But cardiovascular
disease may have partly blocked blood vessels in the brain, the
legs, the kidneys or the heart. Those obstructions, in turn, can
result in exhaustion or mental confusion or weakness or a slow
walking pace.
Investigators say that there is a ray of hope in the finding — if
cardiovascular disease is central to many of the symptoms of old
age, it should be possible to slow or delay – or even prevent – many
of these changes by treating the medical condition.
“It is a new way to think about cardiovascular disease and a new way
to think about aging,” said Dr. Newman with National Institute on
Aging. “With frailty,” she said, “the slowing of gait, the loss of
muscle strength, we had before chalked up to being totally
non-preventable.” Now there is great hope to make a significant
difference in these people’s lives.
When Dr. Newman and her colleagues examined participants in the
Cardiovascular Health Study they saw evidence that their hunch
seemed right: this might indeed be preventable. Participants with
obvious disease who had congestive heart failure or a heart attack
or stroke, for example — were likely to be frail. But those with no
symptoms, with the exception of partly blocked blood vessels seen on
scans and other tests, were nearly three times as likely to be frail
as healthier people. And they became disabled — unable to care for
themselves — about five years earlier than people without
cardiovascular disease at the start of the study.
The researchers emphasize that cardiovascular disease is unlikely to
be the sole cause of frailty. But in explaining frailty among
seemingly healthy people, the findings on cardiovascular disease
made sense. “With a lot of people, slow walking is due to poor blood
flow in the legs,” Dr. Newman says. “Then, their muscles atrophy.
And reduced blood flow to the brain can make people feel sluggish
and depleted and unable to move quickly.”
If they are right about frailty, Dr. Newman and others say the
condition may then be prevented or delayed by not smoking and
keeping cholesterol and blood pressure levels low and by staying
active. Results of lifestyle changes can be powerful – in some cases
more powerful than drugs. And in other cases, very effective when
used in combination with drugs.
These findings are also very good news for today’s middle-age
population who had the advantage of a healthy lifestyle and drugs to
control their blood pressure and cholesterol levels before serious
damage to blood vessels set in. And many are more active than their
parents were when they were middle age – which is a huge advantage
as they progress in years.
New technology saves lives
Did you know that up to 50% of people who have a first heart attack
– which often results in sudden death – don’t experience prior chest
pain, shortness of breath or other red flags for cardiovascular
disease?! An alarming statistic! A heart attack is their first and
only symptom.
It is a grim statistic but the news gets better: In the past,
cardiologists relied solely on the presence of risk factors – a
family history of heart disease, smoking, diabetes, etc. – to
identify “silent” heart disease. As you can imagine, many
opportunities to address potential problems were missed in those
that didn’t present these accepted risk factors. Fortunately, we now
have other, very accurate ways of identifying those at potential
risk. We, here at the St. Helena Center for Health, believe
wholeheartedly in this approach and are routinely utilizing these
screenings with a majority of our ONE clients to determine how
aggressive we need to be with each person in dealing with potential
risk.
There are 2 specific recommended, noninvasive screenings we
currently use that, if used more routinely by a wider range of
physicians, could prevent more than 90,000 deaths from
cardiovascular disease reports the task force for Screening for
Heath Attack Prevention and Education (SHAPE). A powerful statement.
These screenings – a CT scan of the coronary arteries, which detects
Calcium build-up, and a Carotid artery ultrasound, which measures
the amount of plaque present are recommended for virtually all
asymptomatic men ages 45 – 75 and women ages 55 to 75. These tests
can detect arterial changes that are present in the vast majority of
those that would be considered at risk of heart attack.
With these screening tests, doctors can target high-risk patients
more precisely – and recommend appropriate treatment. As a result of
these screenings, patients who test positive for calcium or plaque
in the coronary or carotid arteries should then undergo a cardiac
stress test which detects impediments in circulation through the
coronary arteries and identifies abnormal heart rhythms that can
occur during exercise in patients with heart disease.
Once the risk has been uncovered, there are two very important
factors to pay attention to – and both can usually be modified with
lifestyle changes, medication, or a combination of the two. The
first is blood pressure and the second is cholesterol.
Most patients can significantly lower blood pressure and cholesterol
with even small lifestyle changes – exercising for 30 minutes at
least three to four times a week . . . losing weight, if necessary
eating less saturated fat and/or transfat, and increasing
consumption of fruits, vegetables, whole grains and fish.
Other risk factors that are important to control are smoking,
obesity, diabetes, as well as emotional stress/anger – all of which
may lead to a heart attach or angina. It’s important to control all
of these risk factors because they can amplify each other, or have a
cumulative effect that is much more dangerous than an individual
risk factor.
Beyond the initial screenings
We recently had a client come in for what we all thought was going
to be a routine One day visit. He is young – early 40’s, exercised
fairly regularly, doesn’t smoke, was not overweight, and has no
family history of heart problems. His blood pressure was a bit
elevated but not to the point where it might normally cause concern.
His LDL cholesterol (the “garbage”) was a bit elevated and the HDL
cholesterol (the “garbage trucks”) was somewhat low. We were in for
quite a surprise.
As we conducted the stress test, particularly in anticipation of
normal findings, it seemed there was something very wrong. So
unusual in fact that we almost let him continue past the point where
we would have normally stopped the test if we had earlier suspected
that he might be at risk for cardiovascular disease. Someone with a
stress test like this was most certainly at very high risk for a
heart attack. With further screenings -- the CT scan and Carotid
artery ultrasound – we began to see the scenario unfold that this
young man would soon be in trouble if we didn’t begin immediate
aggressive treatment. What was the most puzzling though was that his
initial cholesterol test didn’t look all that bad. However, when we
received the results from the more in depth cholesterol test offered
by Berkeley Heart Lab a few days later, it all began to make sense.
Half of the nation’s 1.5 million heart attacks each year happen to
people with “normal levels” of cholesterol. The cardiac risk factors
that most physicians have been trained to pay attention to –
smoking, blood pressure, obesity, and the like – still can’t account
for at least a quarter of all heart attacks.
Into the picture steps Ronald Krauss, who was initially an
endocrinologist at the Lawrence Berkeley National Laboratories at
the University of California. Says Kraus, “There are tests that look
beyond the usual definitions of good and bad cholesterol, that
separate the bad from the really bad and the mildly good from the
angelic.” He continues, “Among people who look okay on standard
blood tests, the subtler measures may be much more predictive of
who’s going to get a heart attack and who’s not.” And treatment can
be much more tailored to the individual with results of this
testing.
Using this as an independent predictor of heart disease, Krauss
identified a cholesterol profile that fits one in three American men
around the age of 55, and one in five postmenopausal women. The
diagnosis means that because of genes inherited from one or both
parents, the particles of so-called bad cholesterol (LDL) in the
blood tend to be extra small . . . and extra small and dense means
‘extra bad’. What this means is that arteries of patients with this
pattern of LDL clog faster than those whose cholesterol particles
are larger. And the risk of heart disease among people with this
profile is 300% higher.
The good news is that with treatment they can improve faster too.
With the help of prescription niacin, which has been found to
increase LDL size, cholesterol will shift from the risky pattern (B:
small and dense) to a healthier pattern (A: big and fluffy). And
many patients may then be able to keep their coronary artery disease
in check.
Even though statin use is now prevalent and very effective in
lowering LDL, Krauss and other researchers were bothered by the fact
that large numbers of people were not being helped enough by statins.
For many people, he says, focusing just on LDL “misses where the
action is. At high LDL levels, there’s no question it is a very good
marker. But as you get into the “garden variety” heart-disease
patient whose LDL is only borderline high, you run into trouble if
that’s all you’re paying attention to. For these people, the
“cardiovascular wonder drugs” are a failure.
The demand has grown for the test and out of the demand, the
Berkeley HeartLab in San Mateo, California was established. With a
regular lipid panel you pick up only 50% of heart disease -- with
Berkeley HeartLab you will traditionally pick up another 32% . . .
so a total of 82%. That’s powerful data. With these results, we are
then able to more accurately predict risk and address it properly.
We test everyone in the ONE program and find abnormalities in about
33% of our clients.
Importance of lifestyle changes
It is important to emphasize that although statins reduce the total
amount of LDL in the blood – a crucial first step for anyone who has
very high cholesterol – they generally don’t affect the size of LDL
particles. On the other hand, weight loss of as little as five
pounds can boost particle size. For some people, daily exercise is
enough to drop the pounds needed to shift them from Pattern B to A.
Even without weight loss, exercise has been shown to shift the hard
dense LDL’s to big safer fluffy ones. Diets low in saturated fat
work too. We add niacin to lifestyle change when necessary.
We use the results from this advanced testing, we can create a plan
of action and are seeing wonderful changes in peoples lives.
We plan to continue using all of the excellent tools at our disposal
and to utilize a proactive, preventive approach in helping people
create optimal vibrant good health.
NUTRITION AND LIFESTYLE
The Role of Vegetables in Our Diet – Now More Important than Ever
- Vicki Saunders, MS, RD, NutritionEducator
With the New Year upon us, and some of us paying a penance for our
holiday indulgences, adding a few more vegetables to your usual
mealtime regime is a good way to get back on track. We all know that
“eating our veggies” is a good thing . . . and that we’re always
encouraged to add a serving or two more to our diet. And it’s no
longer just because Mom thought it was a good thing. Many and varied
studies continue to prove that eating vegetables will indeed improve
our health and likely even guarantee a better quality of life for
the long term. And, adding more vegetables to your diet can take a
lot less effort than it may seem.
A Federally funded study at Harvard’s Brigham and Women’s Hospital
in Boston concluded that of the effects vegetables can have on
health, that eating vegetables may help older women keep their
brains sharper. Researchers found that women in their 60’s who ate
more cruciferous and green leafy vegetables (broccoli, spinach,
cauliflower, and romaine lettuce) than other women, went on to show
less overall decline over time on a bundle of tests measuring
memory, verbal ability and attention. Even though this particular
study didn’t include men, they reported there would likely be a
similar affect.
Another study from the Energy Metabolism Laboratory at the U.S.
Department of Agriculture Human Nutrition Research Center on Aging
at Tufts University in Boston, took a look at both low fat and high
fat diets and it was determined that with either diet, it was those
who consume a variety of vegetables that are less likely to be
overweight. Conversely, those whose diet variety is primarily
sweets, snacks, condiments, entrees and carbohydrates, were found to
be a higher percentage of overweight.
In yet another study, dietary variety within food groups was shown
to be an important predictor of body “fatness”, and the direction of
the association depended on which food groups provided the variety,
i.e., if the variety was that of sweets, snacks, condiments, entrees
and carbohydrates, it was positively associated with body “fatness”
whereas when the variety is that of vegetables, it was negatively
associated.
And finally, a study of restaurant food and body fatness showed that
the frequency of consumption of restaurant food was positively
associated with body fatness. Restaurant meals tend to be high in
fat and low in fiber – typically low in vegetable “variety”, and
thus energy dense. Restaurants also typically serve a variety of
palatable foods in large portions.
These are but a few of the recent studies that pay tribute to the
tremendous value vegetables have as a part of a healthy lifestyle.
Here are a few simple tricks to add more vegetables:
• Plan your meals around 1½ to 2 cups of cooked vegetables with a
little protein, carbohydrates and fat to make them interesting. Two
cups of cooked vegetables are an average of 100 calories and they
take up a lot of space on your plate and in your stomach!
• Stretch your ‘carbs’ with vegetables: Make a pasta dish with half
veggies, or a veggie fajita.
• Stretch your proteins with vegetables: Add stir-fried or roasted
vegetables to a sandwich.
• Make a meal of vegetable soup: Make a simple minestrone, tomato,
lentil, or butternut squash soup and have an open-faced sandwich on
the side.
• Make some one-dish meals in the sauté pan using a variety of
vegetables.
• Make one-dish meals as salad, but go light on the dressing.
• Prepare raw vegetables for snacking. Quick, lowfat dips made with
nonfat yogurt or hummus are a good addition.
• In regard to the best way to prepare raw vegetables: Steam,
blanch, stir-fry, roast, or grill vegetables.
• Make vegetable based casseroles.
• Make vegetable sauces for pasta, polenta, rice, fish, chicken,
etc.
• Try vegetable based ethnic dishes – Thai curry, Indian curry,
sukiyaki, ratatouille.
Emotions Have Significant Impact on Health and Longevity
- Steve Wood, MA, MFT, Behavioral Therapist
Research increasingly shows us that emotions that reflect warmth,
acceptance, forgiveness, and love have a positive impact on health
and longevity. Connecting those emotions to behavior sometimes
creates what we call altruism, and the positive effects of this
appear manifold.
Will acts of kindness and generosity enhance our health, increase
our longevity and make us happier? Can heart-directed altruism be a
remedy for stress? As reported by the Institute of HeartMath, when
we act on behalf of other people, research shows we feel better,
more secure, and experience less stress.
Using MRI scans, scientists have identified specific regions of the
brain that are very active during deep and compassionate emotions.
Neurochemicals also enter into this picture of altruism. A recent
study has identified high levels of the hormone oxytocin in people
who are very charitable toward others. But what about the heart?
Leading neurocardiologist, Dr. J. Andrew Armour, has found the heart
contains cells that synthesize and release hormones such as
epinephrine (adrenaline) and dopamine, among others. More recently
it was discovered that the heart also secretes oxytocin, commonly
referred to as the “love” or “bonding” hormone. Remarkably,
concentrations of oxytocin produced in the heart are as high as
those found in the brain. When you are altruistic – lending a
helping hand – your oxytocin level goes up, which helps relieve your
stress. Altruistic behavior also may trigger the brain’s reward
circuitry – the feel-good chemicals such as dopamine and endorphins.
Research shows that altruistic people are healthier and live longer.
In a British poll of volunteers, half of those surveyed said their
health had improved over the course of volunteering. One in five
even said that volunteering had helped them lose weight. Another
large research study found a 44% reduction in early death among
those who volunteered – a greater effect than exercising four times
a week.
Recently, a University of Michigan’s Institute for Social Research
study found that older people who are helpful to others reduce their
risk of dying by nearly 60% compared to peers who provide neither
practical help nor emotional support to relatives, neighbors or
friends.
So, the next time you consider what more you can do for your
wellbeing, consider assisting others in your community. We are
social animals, and altruism, which is a social behavior, is a
win-win for everyone!
Resolution Optimal Health
- Lisa D. Hinz, Ph.D
When making New Year’s resolutions for better health in the upcoming
year, most of us only make resolutions that impact our physical
health. We pledge to exercise more and finally eat a well-balanced
diet. You know the drill.
Areas other than our physical health are often taken for granted
though. It is important that we also include four additional areas
of “health” in order to create the best possible opportunity for
complete success: emotional, social, spiritual, and intellectual.
We can keep ourselves emotionally healthy by being cognizant of, and
addressing, day-to-day stressors, by relaxing, and enjoying leisure
time. Social health means making sure that we have an appropriate
amount of interaction with family, friends and our community. We
ensure spiritual health by practicing our faith and finding meaning
in life by giving to, and helping, others. Finally, we pay
well-heeded attention to our intellectual health when we make sure
that our minds are adequately stimulated through challenging work
and leisure activities.
With the advent of this new year, take a moment to assess what these
five areas are for you and how you can make strides toward
improvement in each area. Resolve to better each area of health as
the year unfolds while you continue your quest toward optimal health
for the long term.
